George, Richard Wayne

George, Richard Wayne is an individual health care provider with primary practice located at 1 Lincoln Parkway Suite 202, Hattiesburg MS 39402. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. George, Richard Wayne can be contacted via phone (601) 288-8050.

Contact Information

Primary practice address
1 Lincoln Parkway Suite 202 Hattiesburg MS 39402
Phone: (601) 288-8050
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R871707 Mississippi

Profile Details

NPI number 1194768242
LBN Legal business name George, Richard Wayne
Credentials FPMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Nov 30th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194768242 NPPES
Mississippi MEDICAID 00203711
Mississippi MEDICAID 891009860

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